Curriculum

The Orthopedic Adult Reconstructive Surgery Fellowship offered at Houston Methodist is designed to provide the fellow with a well-rounded clinical and high-level research fellowship experience in total hip and knee replacement. The fellow will receive exposure to different surgical approaches and different types of arthroplasties.

Houston Methodist serves as a regional referral area for complex cases, which will broaden the fellow’s experience. In addition to traditional hip and knee replacement surgery, the arthroplasty surgeons perform uni-compartmental knee arthroplasty, osteotomies of the knee, and surface-replacement arthroplasty of the hip. The fellow will participate in a large revision surgery practice and will assist in the operative treatment of patients with infected joint replacement and concomitant severe bone loss. Both modular and non-modular prostheses are used for revision hip surgery.

Fellows will develop an understanding of ethical, socioeconomic and medical/legal issues that affect patient care. They will also learn how to apply appropriate utilization management and cost containment measures, while providing quality patient care.

Houston Methodist provides many didactic activities, including non-orthopedic conferences involving active clinical and research divisions, and 17 other Accreditation Council for Graduate Medical Education (ACGME)-accredited residency programs. The fellows will participate in various educational activities at Houston Methodist. Participation in institutional orientation, education programs and other activities involving medical center faculty is required. Didactic activities of the fellowship will include a weekly total joint replacement teaching conference with a defined syllabus designed to cover the field of hip and knee surgery. At the completion of the academic year, the fellow will have accumulated a library of didactic presentations. In addition to providing comprehensive general orthopedic care, the orthopedic surgery service maintains a strong research effort that further enhances its clinical services.

The fellow will have a designated research day every week to devote the necessary time and attention to the study and completion of the research topic or topics. The goal of the fellowship year is to enable the fellow to practice adult reconstructive surgery at the highest clinical level and to equip the fellow for a possible academic career.

Block Rotation Schedule
We have two rotations in our adult reconstructive surgery fellowship training. Each fellow will rotate for three months at a time in each rotation. The surgical case mix of hip and knee surgery is approximately split with 30 percent of the cases categorized as revision surgical cases.

Rotation with Stephen Incavo, MD
Fellows will be exposed to hip replacement surgery performed via the antero-lateral approach to the hip joint. In revision surgery, the fellow will become experienced with femoral augments, acetabular cages, extended trochanteric osteotomy and allograft augmentation. Both modular and non-modular prostheses are used for primary and revision hip surgery. Dr. Incavo performs osteotomies on the knee, as well as uni-compartmental arthroplasty. In knee replacement surgery, Dr. Incavo uses PCL retaining, sacrificing and substituting designs. Periprosthetic fracture treatment will also be included the fellowship year.

Day

AM

PM

Monday

OR (Surgery)

OR (Surgery)

Tuesday

OR (Surgery)

OR (Surgery)

Wednesday

Office (Outpatient)

Office (Outpatient)

Thursday

Office (Outpatient)

Office (Outpatient)

Friday

Didactics/Research

Research

Rotation with Terry A. Clyburn, MD and William Bryan, MD
Fellows will be exposed to hip and knee replacement surgery. Fellows will be exposed to total hip replacement preformed via the posterior approach to the hip joint. Dr. Bryan specializes in primary joint replacements with advanced pain management, rapid recovery and anticipated discharge at 24 hours. His priority is total knee replacements and it constitutes 75% of his surgical cases.